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Mike Keith and Susanne live in Massachusetts, USA. He was 60 when he was diagnosed in January, 2006. His initial PSA was 5.50 ng/ml, his Gleason Score was 6, and he was staged T1c. His choice of treatment was External Beam Radiation (Proton Beam). Here is his story.

Was diagnosed in January of 2006 after a biopsy of 12 cores (had another in 2003--negative then). One of 12 had < 5% adenocarcinoma. PSA dropped to 4.2 ng/ml last test a month ago. No palpable nodules.

In active surveillance for the time being. Am undecided in long term. If I hold steady, I'll continue with AS. If not, I'll likely opt for proton beam therapy. Will update shortly.

UPDATED

May 2006

I had a second opinion on my path slides and this pathologist upgraded my Gleason to a 3+4. He also declared a second core sample to have adenocarcinoma, not just one as was the call of the first pathologist.

Both agree that I have no perineural invasion and only < 5% core involvement in the 1 or 2 positive samples. Learned from docs that grading of slides is very subjective and one place may read on the "high" side while another may read on the "moderate" side, so a third opinion may be a good idea if two path reports conflict.

My first doc stands by the Gleason 3+3 and says I am a good candidate for active surveillance. Meanwhile, the second doc whose pathologist upgraded my Gleason encourages treatment.

This underscores the universal uncertainty that surrounds PCa diagnosis. It does create a quandary for the watchful waiter in me, but I've decided on treatment anyway, which will be proton beam at MGH. I'm told with my low volume and contained cancer, it should succeed. See the Proton Bob site for more information on proton beam treatment. A veritable fan club of hundreds of PB patients is pretty convincing evidence as to the efficacy of this form of treatment.

UPDATED

December 2006

I completed proton beam radiation treatment August 11, 2006, at MGH. My PSA prior to treatment was 4.0 ng/ml. My first PSA since treatment (December 8) was 0.54 ng/ml. My DRE is normal and side-effects have been almost non-existent. The treatment itself was a breeze. So far so good.

UPDATED

February 2007

In the course of the same month, I was given two PSA tests. The first test (December 6) was the first I'd had since treatment last August, and it was 0.54. The second one (December 26) was during my annual physical, and it was 0.40. I'm symptom free, and everything is working normally.

UPDATED

February 2007

A year ago I completed proton treatment. My initial post-treatment PSA was 0.53 ng/ml, and it currently is 0.35 ng/ml. I have no incontinence or impotency. Some expected minor rectal bleeding and inflamation, but it will go away, I'm told. Otherwise, things are fine.

UPDATED

October 2007

My last PSA in September (07) was 0.08 ng/ml. I've been taking Finasteride to shrink my prostate, so it has likely lowered my PSA some--up to 50 percent is possible. Even at that, my PSA would be down sharply (to 0.16) from the last time. Am hopefully heading to a zero-zero nadir. I have some increased night time frequency (2 or 3 times) in visits to the john and occasional rectal bleeding, but I'm told both will abate.

Otherwise, all seems well.

UPDATED

December 2008

Mike's PSA is 0.05 and he says:

I'm now checked by my treatment doctor once annually and get a PSA twice a year. Due for my next one in about a month. All is steady.

UPDATED

March 2010

It's going on 4 years since my treatment and my PSA continues to be under zero. No real side effects. Periodic or occasional minor rectal bleed. DRE's all good. See my urologist once a year.

UPDATED

March 2011

Nearly five years out of treatment and PSA remains same (0.1). Nothing new to report. Still get occasional rectal bleeding but am told that is nothing to worry about. Had a colonoscopy 3-4 years ago and was fine.

UPDATED

February 2012

Things have thankfully remained status quo regarding PSA. Last June (2011) it was up fractionally to 0.37. in January (2012) was back down to 0.11. This June will mark 6 years out of treatment. No new side effects. Still occasional rectal bleeding.

UPDATED

July 2012

My last PSA was less than zero, as they say. It's been six years since treatment and all seems well. Just had second colonoscopy and it was clear.

UPDATED

May 2013

No longer required to check in with my MGH doc. Get a PSA once a year. All's well . . .

UPDATED

June 2014

My status has not changed since my last entry.

UPDATED

July 2015

My status has not changed since my last entry.

UPDATED

September 2016

After nearly ten years of proton beam radiation all is stable.

Mike's e-mail address is: mckradio AT comcast.net (replace "AT" with "@")


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